| NPI | 1568649945 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL L WACH President 909-623-4484 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: CA E4125) |
| Enumeration Date | 2008-01-28 |
| Last Update Date | 2012-12-26 |